The paper summarized common features of financial regulations of public hospitals in developed countries,and proposed the directions and pathways for reforming such systems in China, aiming at providing policy references for the government in reforming urban public hospitals in China.

Objective To investigate the status quo of the assurance and subsidy for severe diseases acquired by juvenile in rural areas in Qinghai, and provide evidences for building a subsidy system for such population. Methods Quantitative surveys were made to collect data on medical expenses and the compensation practice for such expenses for severe diseases of juvenile in the area, for a knowledge of the present medication and disease load in question; specialists in two hospitals were interviewed to learn the present treatnents for such a population, and their expenditures in case of such diseases. Results Juveniles in rural Qinghai rely on the new rural cooperative medical scheme, under which however the reimbursement rate was only 26% ～35%. Families with juvenile patients of severe diseases were found to suffer heavy burdens. As a result, a high percentage of the patients give up treatment. To make things worse, as only two hospitals in the provincial capital city can provide professional treatment for children with severe diseases, rural children have to pay heavy indirect costs other than medication such as heavy travel expenses. Conclusion It is critical to build a medical assurance system for juvenile with severe diseases. It is also imperative to build and strengthen the capacity of medical centers for such a population in Qinghai, and upgrade the diagnosis and treatment competence of local health providers, ensuring adequate medical resources for juvenile with severe diseases upon joint development of both healthcare providers and the medical insurance system.

Objective · To survey the willingness to enroll in nursing homes among the elders in Shanghai and explore its predictors. Methods · A field survey was performed to collect data from 641 elders aged 60 years old and above in six community health centers in Shanghai. Sociodemographic variables, willingness to use nursing home, perceived barriers and perceived benefits were measured. Results · The questionnaire is with good structural validity and good intrinsic reliability. KMO index, P value of Bartlett's test of sphericity, and the range of Cronbach's α coefficients were 0.862, 0.000,and 0.739-0.824, respectively. Among the respondents, 46% were willing to enroll in a nursing home in this survey. Age had significant influence on their willingness (P=0.045). After adjusting for age, the multivariate Logistic regression analysis showed that shame (OR=0.76, 95% CI=0.62-0.94), adaptability (OR=0.61, 95% CI=0.50-0.74) and perceived benefits (OR=1.63, 95% CI=1.32-2.03) were related to willingness (P<0.05).Conclusion · Elders in Shanghai have a relatively high level of willingness to enroll in nursing homes, especially the elders aged from 60 to 69. Shame and adaptability of elders, and the services provided by nursing homes were the predictors of the elders' willingness.

With the continuous deepening of public hospital reform and implementation of internal control systems in China, comprehensive evaluation of the implementation effect of internal control systems in public hospitals is gaining greater weight. To explore the comprehensive evaluation method for such aspect, the authors selected 31 indexes in 6 dimensions based on the analysis of evaluation indexes to construct a comprehensive evaluation index system. The Delphi method was used to determine the relative weight of each evaluation index, and a fuzzy comprehensive evaluation model for the implementation effect of the internal control system in public hospitals was constructed. This paper conducted an application study on the comprehensive evaluation of the implementation effect of the internal control system in a hospital in Suzhou to verify the effectiveness of the model, and a comprehensive evaluation of the implementation effect of the internal control system in the public hospital was implemented. These efforts provided an effective management method for analysis of the implementation effect of the internal control system in public hospitals.

The paper analyzed the internal causes of the corruption risk control mechanism at public hospitals in China. Based on the current development of such mechanism, the authors proposed such measures as pre-warning, intermediate supervision and follow-up actions against the corruption risk exposure commonly found at such hospitals. These efforts aim at further improvement of the corruption risk control of the hospitals.

Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.
China ; Focus Groups ; Health Care Reform ; organization & administration ; Health Personnel ; economics ; Hospitals, Public ; classification ; economics ; trends ; Humans ; Qualitative Research

Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 2011 reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P< 0.001) after adjusting for other independent variables. Self-reported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.

Thanks to the support of relevant national policies since 2018, Internet hospitals in China had developed rapidly. The authors sorted out the current situation of Internet hospital management and construction in China through policy document search and literature search, and found such loopholes as lack of unified supervision and process supervision, barriers between online and offline one-stop services, obsolete information interoperability and network security technology, and poor doctor-patient satisfaction and treatment efficiency. It is recommended to establish a provincial-level standardized supervision and evaluation system, explore an integrated online and offline medical service system, improve the hospital informationized operation guarantee system, promote the improvement of doctor-patient communication satisfaction system, and further promote the development of Internet hospitals in China.

As a standard component in medical education in many countries, standardized patients have become professionals who provide valuable opportunities for training and evaluation of clinical skills among medical students and physicians. This paper reviewed the application of standardized patients in health care, discussed its advantages and disadvantages, and advocated continuation of in-depth research on standardized patients in China, and acceleration in the establishment of a formal system of standardized patients in medical education and health systems, so as to improve the quality of medical care.

The outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. As of May 30, 2020, a total of 84 568 confirmed COVID-19 cases have been recorded in China, with a mortality rate of approximately 5.5%. Taizhou is a prefecture-level city in Zhejiang Province. A total of 146 cases were diagnosed in this epidemic, with a fatality rate of 0%. This condition is due to the establishment of an "Internet +" diagnosis and treatment model based on online medical application (APP), telemedicine, WeChat service, and consultation hotline in Taizhou. Taizhou led in opening the "COVID-19 Prevention and Treatment Special Line" in China, which is conducive to pre-hospital screening, suppressing social panic, and clinical support. Hospitals also carried out related online lectures and popularization of science. We summarize Taizhou's COVID-19 prevention and control experience with telemedicine features, with a view to providing reference for the control of the epidemic at home and abroad.
Betacoronavirus ; China ; Coronavirus Infections ; prevention & control ; Humans ; Internet ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; Telemedicine ; organization & administration